Strattice Breast Augmentation Revision: Uneven and Bumpy

I am two days post of from a breast augmentation revision. I went from approx 400cc saline under muscle to 375 silicone moderate profile plus under muscle.
Strattice was used laterally and i think underneath as well (the old implants had shifted into my armpits.)
I'm 5'1 99lbs. I have drains too. The outsides, by my armpits, have a concave indentation in them, and it's swollen under my armpits in an uneven way.From front view they look uneven and one almost saggy?? I'm a little concerned.

Doctor Answers (7)

2 days post augmentation revision--uneven and bumpy.

+3

You had major breast revision surgery--use of Strattice to reinforce your breast pockets is both extensive and expensive! At this point I am not at all concerned with your early appearance (Thanks for the photos), but I must confess I am a bit concerned with the use of drains. Fluid or blood out may be better than allowing it to remain in the pockets, BUT the drains are a direct portal to your implants and can also allow bacteria IN!

This, IMHO, increases your risk of capsular contracture, or even infection. Both are serious complications, may require re-operation (removal of implants in the case of infection), and could have been risk-reduced by avoiding drains. Perhaps your surgeon was concerned enough with bleeding intra-operatively that drains were deemed necessary. I know it's too late for this individual situation now, but would recommend extreme caution and technique in emptying your drain and keeping your drain site through your skin clean and protected with a small barrier of Betadine ointment (it's brown and messy, but kills many more bad things than Bacitracin alone).

Let things heal and settle before becoming concerned about your appearance. What you are seeing and describing is a normal part of the healing process. Keep your activities low and see your doctor as recommended. (Get those drains out ASAP) Best wishes!


Minneapolis Plastic Surgeon
5.0 out of 5 stars 106 reviews

Bumps Can Be Normal 2 Days Post-Op

+2

While it can be distressing to see bumps, swelling and contour irregularities after a cosmetic procedure, more often than not, that's to be expected due to swelling.

Drains are not unusual as part of the normal routine after using acellular dermal matrix (Strattice).  It is true that surgeons should be judicious in the election to use drains, especially with implants, but using drains after placing a graft like Strattice is common.

The decision to use Strattice is one where experts may disagree, but I wouldn't second guess that choice on the basis of your posting. Some plastic surgeons are unconvinced of the value  of Strattice, while many of us plastic surgeons would advise the use of acellular dermal matrix to improve the chances of success in a situation like yours.

Stay closely in touch with your surgeon about your concerns; the photos don't give a clear enough image to discern if there is a problem.

The drape of your breast is very important, but you are a bit too soon after surgery to determine if your breast will appear droopy, or will turn out great, once the swelling goes down and the tissues settle a bit.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 7 reviews

Revision results

+1
Your fears about the areas of bumps and asymmetry are normal. But for the most part, these are temporary problems and will resolve. The material and the surrounding tissues will meld and incorporate. It may take as long as a year to resolve, but you should be assured that most will improve.

Archibald S. Miller, MD
Tulsa Plastic Surgeon
3.5 out of 5 stars 3 reviews

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+1

Things look totally normal for now...it is recommended that drains be used with strattice, so that is quite normal.  Often, the strattice is sewn in place with absorbable sutures that will temporarily distort the overlying skin.  Patience for now.  The drains should be removed soon.  Followup with your surgeon and let things heal and settle.

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Revision surgery can be difficult and frequently have more edema and take a longer time to heal than the primary procedure. I usually tell patients to be give it time as nothing will usually be done in the early post operative period

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Too early to worry

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Revisional breast surgery especially attempts to control pocket with implanted materials is substantial surgery that will swell and undergoe many changes over the following weeks to months. Two days is too early to be concerned.

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Breast revision

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At two days out you should not be over analysing your breasts. They will change significantly with time. This could mean they could get better or worse but no sense stressing about it now. Follow your surgeons instructions regarding post operative care.

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.